Maimaiti Yasenjiang, Cheng Hui, Guo Zitong, Yu Xiaolin, Tuohuti Adilijiang, Li Guoqing
Gerontology Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China.
Department of Cardiology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China.
Front Cardiovasc Med. 2023 May 23;10:1085122. doi: 10.3389/fcvm.2023.1085122. eCollection 2023.
To investigate how serum GDF-15 concentration affects pulmonary artery hemodynamics and pulmonary vascular morphological changes in patients with pulmonary arterial hypertension.
A total of 45 patients admitted to our hospital from December 2017 to December 2019, were selected for the study. Pulmonary vascular hemodynamics and pulmonary vascular morphology were detected by RHC and IVUS. Serum GDF-15 levels were detected by enzyme-linked immunosorbent assay (ELISA). Based on the concentration of GDF-15, the patients were divided into two groups-the normal GDF-15 group (GDF-15 <1,200 pg/ml, 12 cases) and the elevated GDF-15 group (GDF-15 ≥1,200 pg/ml, 33 cases). A statistical analysis was performed to compare the effects of normal blood GDF-15 levels and high serum GDF-15 levels on hemodynamics and pulmonary vascular morphology in each group of patients.
The average levels of RVP, sPAP, dPAP, mPAP, and PVR in patients with elevated GDF-15 levels were higher than those in patients with normal GDF-15 levels. The difference between the two groups was statistically significant ( < 0.05). The average levels of Vd, elastic modulus, stiffness index β, lesion length, and PAV in the normal GDF-15 group were lower than those in the elevated GDF-15 group. The average levels of compliance, distensibility, and minimum l umen area were higher than those in the elevated GDF-15 group. The difference between the two groups was statistically significant ( < 0.05). The survival analysis results showed that the 1-year survival rate of patients with normal GDF-15 levels and elevated GDF-15 levels was 100% and 87.9%, respectively, and that the 3-year survival rate of patients with normal GDF-15 levels and elevated GDF-15 levels was 91.7% and 78.8%, respectively. The survival rates of the two groups were compared by the Kaplan Meier method, and the difference was not statistically significant ( > 0.05).
Patients with pulmonary arterial hypertension with elevated GDF-15 levels have higher pulmonary arterial pressure, higher pulmonary vascular resistance, and more serious pulmonary vascular lesions, which are potentially more harmful. There was no statistically significant difference in survival rates among patients with different serum GDF-15 levels.
探讨血清生长分化因子15（GDF-15）浓度对肺动脉高压患者肺动脉血流动力学及肺血管形态变化的影响。
选取2017年12月至2019年12月我院收治的45例患者进行研究。通过右心导管检查（RHC）和血管内超声（IVUS）检测肺血管血流动力学和肺血管形态。采用酶联免疫吸附测定（ELISA）法检测血清GDF-15水平。根据GDF-15浓度将患者分为两组——GDF-15正常组（GDF-15<1200 pg/ml，12例）和GDF-15升高组（GDF-15≥1200 pg/ml，33例）。进行统计学分析，比较正常血GDF-15水平和高血清GDF-15水平对每组患者血流动力学和肺血管形态的影响。
GDF-15水平升高患者的右心室压力（RVP）、收缩期肺动脉压（sPAP）、舒张期肺动脉压（dPAP）、平均肺动脉压（mPAP）和肺血管阻力（PVR）平均水平高于GDF-15水平正常患者。两组间差异有统计学意义（<0.05）。GDF-15正常组的血管直径（Vd）、弹性模量、硬度指数β、病变长度和肺动脉面积（PAV）平均水平低于GDF-15升高组。顺应性、扩张性和最小管腔面积平均水平高于GDF-15升高组。两组间差异有统计学意义（<0.05）。生存分析结果显示，GDF-15水平正常和升高患者的1年生存率分别为100%和87.9%，GDF-15水平正常和升高患者的3年生存率分别为91.7%和78.8%。采用Kaplan-Meier法比较两组生存率，差异无统计学意义（>0.05）。
GDF-15水平升高的肺动脉高压患者肺动脉压力更高、肺血管阻力更高且肺血管病变更严重，潜在危害更大。不同血清GDF-15水平患者的生存率差异无统计学意义。
